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Case Report: Late-Onset Temporal Lobe Epilepsy Following Subarachnoid Hemorrhage: An Interplay Between Pre-existing Cortical Development Abnormality and Tissue Damage

Epileptogenicity following brain insult depends on various factors including severity of the resulting lesion and extent of brain damage. We report a 54-year-old female patient who developed medically refractory epilepsy resulting from the interplay of pre-existing and post-insult pathologies. She p...

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Autores principales: Ikawa, Anna, Fujimoto, Ayataka, Arai, Yoshifumi, Otsuki, Yoshiro, Nozaki, Toshiki, Baba, Shimpei, Sato, Keishiro, Enoki, Hideo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7901922/
https://www.ncbi.nlm.nih.gov/pubmed/33633663
http://dx.doi.org/10.3389/fneur.2021.599130
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author Ikawa, Anna
Fujimoto, Ayataka
Arai, Yoshifumi
Otsuki, Yoshiro
Nozaki, Toshiki
Baba, Shimpei
Sato, Keishiro
Enoki, Hideo
author_facet Ikawa, Anna
Fujimoto, Ayataka
Arai, Yoshifumi
Otsuki, Yoshiro
Nozaki, Toshiki
Baba, Shimpei
Sato, Keishiro
Enoki, Hideo
author_sort Ikawa, Anna
collection PubMed
description Epileptogenicity following brain insult depends on various factors including severity of the resulting lesion and extent of brain damage. We report a 54-year-old female patient who developed medically refractory epilepsy resulting from the interplay of pre-existing and post-insult pathologies. She presented with subarachnoid hemorrhage (SAH) due to a ruptured aneurysm and underwent clipping surgery. Seizures started 3 months post-operatively. MRI revealed cerebral ischemia and hemosiderin deposits in the left temporal lobes, and left hippocampal atrophy was suspected. As anti-seizure medications and vagus nerve stimulation failed to control her seizures, she underwent left temporal lobe resection and placement of a ventriculoperitoneal shunt for the post-operative complication of hydrocephalus. She remains seizure-free to date. Neuropathology revealed a previously undiagnosed focal cortical dysplasia (FCD) type 1a. Brain insult likely had a second hit effect in the late onset of epilepsy in this patient with pre-existing mild MCD, in whom secondary epilepsy can be attributed to the interplay of multiple underlying pathologies.
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spelling pubmed-79019222021-02-24 Case Report: Late-Onset Temporal Lobe Epilepsy Following Subarachnoid Hemorrhage: An Interplay Between Pre-existing Cortical Development Abnormality and Tissue Damage Ikawa, Anna Fujimoto, Ayataka Arai, Yoshifumi Otsuki, Yoshiro Nozaki, Toshiki Baba, Shimpei Sato, Keishiro Enoki, Hideo Front Neurol Neurology Epileptogenicity following brain insult depends on various factors including severity of the resulting lesion and extent of brain damage. We report a 54-year-old female patient who developed medically refractory epilepsy resulting from the interplay of pre-existing and post-insult pathologies. She presented with subarachnoid hemorrhage (SAH) due to a ruptured aneurysm and underwent clipping surgery. Seizures started 3 months post-operatively. MRI revealed cerebral ischemia and hemosiderin deposits in the left temporal lobes, and left hippocampal atrophy was suspected. As anti-seizure medications and vagus nerve stimulation failed to control her seizures, she underwent left temporal lobe resection and placement of a ventriculoperitoneal shunt for the post-operative complication of hydrocephalus. She remains seizure-free to date. Neuropathology revealed a previously undiagnosed focal cortical dysplasia (FCD) type 1a. Brain insult likely had a second hit effect in the late onset of epilepsy in this patient with pre-existing mild MCD, in whom secondary epilepsy can be attributed to the interplay of multiple underlying pathologies. Frontiers Media S.A. 2021-02-09 /pmc/articles/PMC7901922/ /pubmed/33633663 http://dx.doi.org/10.3389/fneur.2021.599130 Text en Copyright © 2021 Ikawa, Fujimoto, Arai, Otsuki, Nozaki, Baba, Sato and Enoki. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Ikawa, Anna
Fujimoto, Ayataka
Arai, Yoshifumi
Otsuki, Yoshiro
Nozaki, Toshiki
Baba, Shimpei
Sato, Keishiro
Enoki, Hideo
Case Report: Late-Onset Temporal Lobe Epilepsy Following Subarachnoid Hemorrhage: An Interplay Between Pre-existing Cortical Development Abnormality and Tissue Damage
title Case Report: Late-Onset Temporal Lobe Epilepsy Following Subarachnoid Hemorrhage: An Interplay Between Pre-existing Cortical Development Abnormality and Tissue Damage
title_full Case Report: Late-Onset Temporal Lobe Epilepsy Following Subarachnoid Hemorrhage: An Interplay Between Pre-existing Cortical Development Abnormality and Tissue Damage
title_fullStr Case Report: Late-Onset Temporal Lobe Epilepsy Following Subarachnoid Hemorrhage: An Interplay Between Pre-existing Cortical Development Abnormality and Tissue Damage
title_full_unstemmed Case Report: Late-Onset Temporal Lobe Epilepsy Following Subarachnoid Hemorrhage: An Interplay Between Pre-existing Cortical Development Abnormality and Tissue Damage
title_short Case Report: Late-Onset Temporal Lobe Epilepsy Following Subarachnoid Hemorrhage: An Interplay Between Pre-existing Cortical Development Abnormality and Tissue Damage
title_sort case report: late-onset temporal lobe epilepsy following subarachnoid hemorrhage: an interplay between pre-existing cortical development abnormality and tissue damage
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7901922/
https://www.ncbi.nlm.nih.gov/pubmed/33633663
http://dx.doi.org/10.3389/fneur.2021.599130
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